Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
• perform the following laboratory tests to evaluate the woman’s health and screen for
selected medical conditions and infections:
o hemoglobin levels (as needed).
o RPR (or VDRL): The test should be done if the woman’s status is not known.
o HIV (first visit/if last test >3 months ago/as needed): If the woman does not know
her status and volunteers for testing, a test should be conducted. A positive HIV
status affects many aspects of care for the woman and her newborn.
o check CD4 count according to national protocols if the woman’s HIV status is
positive.
• provide prophylaxis for health promotion and disease prevention: TT, intermittent
insecticide-treated bednets (ITN), iron/folate tablets, vitamin A, broad-spectrum antihelminthics,
and other nutritional supplements as needed.
• promote safer sexual practices.
• if the woman’s HIV status is positive, provide prophylaxis for opportunistic infections
according to national guidelines.
• provide treatment for any medical conditions, illnesses, and infections detected.
• manage any pregnancy-related complications.
• provide PMTCT interventions according to national guidelines. If the woman is not
already on ARV treatment, consider referring her for care with an HIV specialist.
• provide client-centered counseling for women and partners/supporters.
• help the woman and her partner/support person develop a complication-readiness plan.
• refer all women who need specialized care for any reason.
Importance of Routine Couple Visits
A routine couple visit prior to discharge from the facility enables discussion with the
partner/father about warning signs of complications in the woman and newborn and the need to
make a plan for urgent transport and referral. He can also learn what he can do to protect his
wife's and newborn’s health and understand the importance of exclusive breastfeeding. In these
ways a couple discharge visit can contribute to maternal and perinatal health.
The couple visit also provides an opportunity for both partners to be educated about treatment
and prevention of sexually transmitted infections, the importance of family planning, and the
availability of different family planning methods, including vasectomy.
If the male partner has not yet been tested for HIV, the couple can be counseled and
encouraged to be tested without the danger of blame being put on the woman because she has
been tested first. Where appropriate, condoms can be demonstrated, promoted, and provided.
A couple visit acknowledges the usual gender role of men in protecting their family and in
making decisions.
Health Promotion and Disease Prevention
Certain medications or simple health care measures can prevent or reduce the risk of suffering
from specific health problems. The following measures should be explained and offered to all
women.
Integrated maternal and newborn care
Basic skills course
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